Before Your Visit with Dr. Smith New Patient Forms
We’ll need the information on the form prior to getting started. Please download the form, complete it and bring it to your first visit. If you are not able to complete these forms prior to your first visit, please arrive 20 minutes before your scheduled appointment.
Please note: pregnant patients will need to fill in BOTH the Adult Health Profile AND the Perinatal Supplement Intake forms.
Youth ages 9-16 will require parents to complete the Youth Health Profile, which you can also download below.
Children ages 0-8 years will require parents to complete the Pediatric Health Profile, which you can download below.
Let us be absolutely clear, chiropractic is NOT a cure or treatment for any disease, condition or symptom; however when your spine and nerve system is working optimally, your ability to heal, to recover and to be healthy drastically improves!
The symptoms and conditions listed above (+ many more) are most often what we call secondary conditions, caused by a handful of primary conditions one of which is structural distortions in your spine that effect how your brain and body function and communicate.
Our job is to figure out if the secondary conditions that you’re currently suffering from are caused by primary problems located in your spine and nervous system.
If they are, we can help; if they’re not we’ll let you know and refer you to the appropriate health care professional.